Moving Schizophrenics into the Community Does Not Increase Crime
WebMD News Archive
In the study, schizophrenic men from both the 1975 and 1985 groups were more
likely than controls to have a criminal record (24% vs. 7.4%), and they had
higher rates of criminal convictions than controls in all categories except
sexual offenses. The overall patterns of offending from 1975 to 1985, however,
did not differ statistically between schizophrenics and controls.
The researchers write that the increased number of convictions in those with
schizophrenia in the 1985 group compared with the 1975 group seems to reflect
an increase in the general population. "Changes in the pattern of mental
health services, with the shift to community care, [were] not marked by any
significant change in relative rates of conviction for those first admitted to
hospital with schizophrenia."
A psychiatric epidemiologist, who works with a community-based treatment
program for mentally ill people judged not guilty by reason of insanity, tells
WebMD that such programs need community support and adequate resources to
"Why would someone with a history of mental illness commit some violent
act? It's usually the people who are not adhering to their treatment regimen,
they have problems with substance abuse, or there's no effective treatment in
the community, so they're not getting the treatment that they need for it,"
says Howard Kravitz, DO, MPH, associate professor of psychiatry and preventive
medicine and director of research for the section of psychiatry and the law at
Rush-Presbyterian-St. Luke's Medical Center in Chicago. Kravitz was not
involved in the study.
"Overall, among psychiatry patients you probably don't have a higher
risk [of crime] for people with serious mental illness. The problem is that
you've got a small group that will go out and commit violent acts, and those
are the people who make the headlines."
The study's authors say that mental-health services should aim to reduce the
higher crime rates associated with schizophrenia, but that a move away from
community care is not likely to help.
"To return to a situation in which those individuals in the early stages
of a schizophrenic illness spend extended periods in institutions will require
the clock to be turned back several decades, and its influence on offending, if
any, remains unclear," they write, but they go on to emphasize that
"community care may not be responsible for the raised rates of offending,
but it will be held responsible if it does not actively address the prevention
of that offending."